that leaves just two, utah and wyoming. check out cnn.com/stateoftheunion. until then, i'm john king in washington. up next, tom foreman and dr. sanjay gupta and the critical health care debate. a late night senate showdown. we're just one hour away from a major vote on health care reform. democrats say it will pass. and if it does, it will be a huge step towards a massive overhaul of the nation's health care system. hello, i'm tom foreman reporting tonight from washington. >> and i'm dr. sanjay gupta in atlanta. this is special coverage of a crucial senate vote on held care reform. >> members of the best political team are joining us on the late night shift. dana bash is standing by at the capitol. dan lothian is here in

washington and dana gergen and democratic strategist john brazil is on the phone as well. let's head straight to capitol hill first. they are kicking off ap brand new legislative date. dana bash is there. what a day it's been for you, dana. set the scene for us. i have a question about that. is there a risk that someone might not make it in with all of the weather that is going on? >> that's a very good question. i actually just was e-mailing with senior administration official who is monitoring this very closely, as you can imagine, because this is the president's top priority who said that every senator is now here. in fact, the last three senators they were waiting for coming in by amtrack have just arrived. so that really peaks to the big issue here, which is that democrats need every single senator that aligns themselves with democrats to actually vote yes on this very, very critical vote. and we really can't underscore

how much after all of the debate, the talk, and the many, many votes on the house and various committees that when it comes to the biggest hurdle that the president and democrats across the board knew that they had, it was the united states senate and now that democrats do have a compromise that they are going to vote on, the first big vote on this, this will assure, if they are correct in their vote counting, is sure that they have the votes to move forward on health care in the senate and ultimately pass late they are year. many people are asking, well, what does this mean for them? let me give you a couple of quick bullet points. first of all, more importantly, nearly all americans are going to have to actually have health insurance. it will be a requirement and for most people who don't have it, they are going to have to pay a fine f. not. and for people bho are making a family, i should say, making $88,000200 or less, they are going to get government subdiddies for the insurance

that they are now required to get. and for families making $29,000 or less, they will be able to get medicaid w. si a government program that will be expanded to make this new mandate for insurance coverage available to them and affordable. >> i do want to talk a little bit about the cost of this and how they are going to pay for. this but let me ask you for those votes expected at 1:00 a.m. four days before christmas. why now? why in the middle of the night? >> well, the why now just broadly, it's because democrats have been trying so, so hard to get this done as fast as they can. remember, the president's original deadline was to get this bill done by august. that didn't happen because rallying the democratic troopses, again, it's important to underscore, trying to bridge the philosophical divide within the democratic party has been so hard. so the deadline that they have put on themselves is by

christmas. and the way to get this done, democrats say by christmas is to do this. why the late night or early morning, however you look at it? because of the way that the legislative calendar works when the democratic leader was actually able to form this compromise, had he to formally file it, if you will, and the procedure allowed for several hours, actually 30 hours of debate and that ended at 1:00 a.m. or will ends at 1:00 a.m. >> and as you were talking, the senate prayer just ended up there as well. you talked about costs specifically. how did the democrats say that we can pay for this health care bill and i don't know if you've had a chance to analyze all of the numbers but does it breakdown? how does it breakdown? >> well, the gist of it is is $500 billion. how will pay pay for it? $500 billion in spending cuts,

especially to the medicare program. but the rest of it will tax hikes and there will be a lot of tax hikes. there will be a 40% excise tax and high cost insurance plans and fees or taxes on insurance companies and medical device companies and people who makeover $250,000. they will see an increase in medicare payroll tax and there is something new, sanjay. there's a 10% tax on indoor tanning services. it looks like the tanning service lobby is not as strong as the cosmetic surgery lobby because so called botax, that was dropped as well. >> we had talked a lot about that. we'll have a lot more on that. for now let's send it back up to tom. dana, stand by. >> we're going to run over to dan lothian to get the read there. dan, let me ask you a quick question about this. how does the white house feel at this point?

i know they want to get a win out of this but this doesn't really resemble what they were pitching in the first place. the president said that he wanted it in august and now they are struggling to get it done now. is the white house saying, great, this is a victory? or are they saying now we have a lot of repairses to make it pass like the victory that they want? >> well, you are right in pointing out that this looks like what the president was talking about many months ago. he wanted something that would have a public option and he's not getting that at all. they say that they are at the one yard line. they haven't gotten into the goal yet. they believe that they will be able to do that and they will be working very hard. the president engaged behind the scenes trying to make sure that this does happen. they also realize that republicans are going to be throwing up a lot of procedural barriers.

we heard david axelrod talking about that in the end that the will -- there is the will there to make this happen. >> and do they have confidence that they can get enough democrats in the house and the senate with these explosive issues still out there, the debate over abortion, the debate over funding this, the debate on who is going to get hit with the extra payment on this? even the concerns that this could ultimately lead to the president breaking his own pledge about not raising taxes on his own people? >> well, they certainly hope so. that's the big hurdle right now. because you have these two bills going from the house and the senate that will have to be merged and there are differences. one has the public option and the senate version does not have the public option at all. so they are hoping that they can get what they want and ultimately they are saying, you know, what is important here is that 30 some million americans who are uninsured will be able to get insurance. they are saying that some of the problems that you've had with

the insurance companies will be broken down and so it will be a much different system than we currently have. what is interesting is that this is a president who came to washington who said that he was going to change the way that washington worked. he was going to change the way that deals were made in order to get legislation passed and there's a lot of criticism saying that the price is right, that they were willing to give autopsy lot n particular, you saw with ben nelson, getting a lot for his state for the state of nebraska so that they could get the 60 democrats to line up on this. >> and the white house saying that, listen -- >> good evening, john. you make up an interesting point there. because i remember one of the earlier criticisms that stuck for a long time was that as a candidate, barack obama said that we'll have every meeting

opened. people will be able to watch everything that we do and that simply has not been the case. >> they say it's been a lot of transparency. everything that has played out in all of the deal making, if you will, that has been going on, there's been a lot of transparency and they say that, listen, this is what happened, whether it's republicans or democrats, this is what takes place, the american people getting ready to see how the sausage is being made here and some lawmakers will get specific things for their states in order to get their vote. tlashs a lot of criticism when the president talked about what was taking place here in order to get health care reform. >> well check back in with you again. dan, thanks so much for that. sanjay? >> as you can see there as well, the senate is under way at midnight, just after midnight in the historic events taking place here. we're going to see what happens following this very closely, all

of the resources of cnn at play here f you haven't been interested of the health care debate because of too much noise or it's too political, it's been getting interested. since the early 1900s, politicians have tried to provide care for all americans. tonight we're closer than ever before to seeing that promise fulfilled. >> the american system of health care is an accident of history. during world war ii, they try to head off inflation and allows companies to get tax breaks for providing benefits, like health care. today, more than 157 million americans rely on their jobs for health coverage but that safety net is also getting smaller. in just the past ten years, thousands of companies have stopped offering insurance. while at the same time, workers were asked to pay 131% more.

from world war 2, france, britain, canada, not to mention germany emerged with government-run health insurance systems. president true man wanted the same thing here. >> it's about legislation to provide our citizens with the homes that they need, the opportunity for universal good health. >> but the ama fought back. the battle cry? no socialized medicine. true man's plan was defeated. 16 years ago the country was abuzz about the clinton's health plan. that suffered a defeat in 1994 forcing the health care debate out of the spotlight. i saw it firsthand n 1997 and '98 when i worked as a nonpartisan fellow in hillary clinton's office. today more than 14 million americans don't vice president health ints. and that will be the question while we are working, the senate

vote on health care, a very important night, i want to bring in david gergen. good night, i guess, early morning to you. thanks for joining us. you and i have had a lot of opportunity talk about this in the past. you just watched that piece. let me ask you broadly as we get into this, when it comes to this sort of thing, is something better than nothing? this obviously is a very different bill than what a lot of people were expecting a year or 14 months ago. >> a remarkable night in washington. you find people in washington are deeply divided on that very question and so is the country. passing some sort of health care reform and not allowing the status quo to remain, opinion has started to move south on health care reform so that now in some polls, you find the majority of americans it's

better to do nothing than to going back to world war ii, only two presidents and all seven had failed. this will be the first time that the senate of the united states has embraced a universal health care reform plan never happened before. and it's also important to note that i can't remember a time when a piece of legislation this important, this important to the economy or the future of the country has also been passed on a strictly partisan vote. >> >> so who is happy with this? if you take a look at all of the various people interested in

this, which is everybody, who is thrilled tonight? >> well, in the political spectrum, there are some on the left and some on the right. howard dean is representative of the progressive side of the democratic party. and the most urban democrats are pleetsed. they'd like to see it improve and there's going to be this fight. tonight is a big milestone but i think it's increasingly clear. there's going to be a struggle over what the final bill might look like and whether you can hold together the coalition in the house which passed after all just by a majority and still hold together the coalition in the senate. that's going to be a lot of work ahead. but this is a big victory for harry reid as well as president obama and they are very happy tonight. >> let me jump in with a question here. >> sure. >> one of the chief criticisms of republicans is they are

basically saying -- and you can see senator john mccain going to the podium right now. one of the chief complaints is the notion that somehow this is being sneaked through the middle of the night. we're going to take a moment and listen to john mccain and then i want you to respond to that in a moment. let's listen to senator john mccain. >> i don't like to spend too much time recalling it but health care was a big issue in the presidential campaign and on october 8th, 2008, just less than a month before the election, then candidate obama said and i quote, concerning health care reform, quote, i'm going to have all of the negotiations around a big table. we'll have negotiations televised on c-span so that people can see who is making and that was a statement made by then senator candidate obama.

and republicans and the other side. there has never been. i say that with the knowledge, mr. president, of someone who was negotiated many times. across the aisle on many agreements. sop don't stand up and say there never were. but there was negotiations with a special interest, with pharma, the same ones that the president said we was going to be -- was going to see who the american people on the side, clearly this administration and that side of the aisle was on the side of pharma because they got a sweetheart deal of $100 billion that would have been saved and

arp are exempt, the ama signed up because of the promise of a fix. there was throughout this, we should have set up a tent out in front and put persian rugs out in front of it. that's the way that this has been conducted and then we had to take care of special senators and the one deal is called, we've got new words in our lexicon now, the louisiana purchase, the corn husband sker kick back. i got a new name, the florida film flam, the one that gives the and so in answer to, this in answer to a question today, the majority leaders said, quote, a

number of states are treated differently than other states. really? a number of states are treated different than other states. that's what legislation is all about. that's compromise. where is that taught? ? where is that taught? a number of states are treated differently than over states. that's why legislation is all about, let's compromise. my friends, that's not what the american people call governing. that's called exactly what the -- an opposite contradiction of what the president of the united states says and a senator from illinois says, i'm in two. i am give him his own quote. here we are, a senator from tennessee that said in the middle of the night, and here we

are, my friends b. to pass a bill with 60 votes. 60 votes represents 60% of this body. and i can assure myself -- >> and that's senator john mccain on the other side of the aisle. this is the sort of thing they keep saying, abad legislation in the middle of the night right before christmas, this is the way that they can get away with it. is that the middle of the party line? >> very much so. there are a whole bunch of issues all at once there. you heard from john mccain. he summarized them quite well.

and they hended up breaking down. on the issue of trans parn see, the bottom line is, somebody who has tried to cover these negotiations and trying to figure out what has there hasn't been a lot of transparency and it's hard to get details. john mccain is right on that. however, ill tell you that it's business as usual which is the point that john mcskein trying to make. things haven't changed much. >> let me bring you back in here

as well. pharma, various organizations simply were not on board. what i'm hearing, senator john mccain and dana right now, there was a lot of quid pro quo is that fair? >> absolutely. what we're seeing is the fury that exists on the republican side, about the way that this whole thing has been undertaken. dana has a good point there were republicans at the table like olympia snow. they did breakdown but there is a sense, more broadly, and you

will all the way through with tax reform, in '96, what we saw then was buy bart san ship, people were brought to the table and there were votes from both side. we had super majority that passed things. and in instead of having the partisan divide, we had legislation that went through with the sense and the country representing the will of the entire country. and they run straight genks this health care reform.

one thing is, this was all done and perhaps they could find very specifically and very directly to try to keep the coalition on their side. it's important that the reimportation of drugs, they have to be fda approved and there has to be safety issues to be dealt with.

and we see what the deals are and one of the problems s. this is a very complex and very big bill and a lot that we really don't know we're just getting started. stay with us. this is a very big night with a very big vote. when we come back, we'll talk about the high political stakes for the president and his party.

the idea of taking health care reform and getting some legislation that would make a big difference, a democrat from iowa there. beyond the particulars in the health care bill, for the white house and the president's party, we have the best team here to help us sort through all of that. a tremendous number of good folks there. dana bash, david gergen, april ryan, and also joins us, let me start with a quick question here. the democrats truly seem to be putting an awful lot of chips into this kitty and saying, we believe this will really work and for all of the republican anger that we saw from john mccain here, we also see republicans saying to quote john cornyn earlier from texas, there will be a day of accounting for this. they believe that the democrats are making a big mistake that is

going to eat them alive next fall. what do you think? >> well, this is definitely political, politics of politics. but at issue, they are fighting among themselves about this. and tonight this is something that we've seen scene before, many presidents have tried, seven presidents have tried and if he indeed does get some type of health care reform, it may not be the original mandate that he started out with when he was a candidate for president. but if he gets some type of health care reform, within the next few months, this is definitely a big win for him, for his party, and it also translates into the elections, the upcoming elections in 2010

as well as 2012. >> david gergen, let me ask you a follow-up question on that very issue. i asked you earlier that the republicans keep saying that they are husband selling this through in the middle of the night because they don't want people to look at this very closely. whether that is true or not, perception means a lot in politics. that seems like a message to me that could sell well in the country if details are coming out of this thing that bother people. >> i agree with that, tom. and i think that from a democratic point of view, they are going to have a vote at 1:00 in the morning. it will be far better to do this during the working day. but they have this pressure that is built up on them to get this bill passed in the senate before christmas for a couple of reasons. there's a real concern about momentum. there's been a loss of momentum in these polls around the

country. and so there has been a real form among democrats if they don't get this done now, people go home from congress and they wanted to do that and extend too far into the new year because the closer does get to 2010, in november of next year, the more jittery people and if you pass it you may have eight or ten months for things to heal if you pass it by january or february, you may have time to come up, the terrain can change and you can still survive what actually is a very tough vote. you do it much later in the year

and you pass to something unpopular and you have very little recovery final. so there's been real -- there's political reason to get this done. it's -- it is a highly political issue but i must tell you, i think one of the reasons that the country is has turned on this, and it's let's enthusiastic as it was, it's driving the substance and how how important to get it to illustrate it, several of the top aids when it comes to health care are here at this very late hour or early hour, depending on

how you want to look at it. the secretary of human services, kathleen sebelius is in the cal tap for this voight. the deputy chief white house chief of staff, jim, m who has been here a lot, trying to negotiate it and through every minute of these talks, to try to bridge the democratic divide that gives me a sense of how incredibly critical this upcoming vote is. despite all of the talk, all of the votes, the rhetoric in terms of what the president really needs going forward and how close they really think they are to finally getting this, this particular senate vote we'll

have much more after the break. pursuant to the honest leadership act of 2007 and (announcer) some people just know how to build things well. give you and your loved ones an expertly engineered mercedes benz at the winter event going on now. but hurry - the offer ends january 4th.

>> this goes back 40 or 50 years in terms of drafting and efforts that have been made to achieve what we're trying to achieve this evening. at the end of the day, however, the legislation is really about freedom from fears. as i said a moment ago. it frees americans from the fact that if they lose their job, they will never find insurance coverage again. the bill frees americans from the facts that they might get sick and unable to afford the treatment that they need.

and the bill frees americans from the fear that one illness, one accident could cost them everything that they built, their homes, their retirement, their life savings. sustained by unimaginable prosperity, this bill is long over due and politically unimportant. no american can be free from fear the clinton administration, worked tirelessly to craft a good health care bill and talk about the regrets that they have and not acknowledging his ideas when he proposed them. he might not have -- we might have been able to address this issue years and years ago. so good people have tried to

come up with some answers to this issue. it's with a note of sadness that we're going to have a partisan vote on this matter. i wish it was otherwise. i'd like to point out that many of us have fought and challenged is to come up with these answers. the senator harkin just pointed out, it's finally the last address these issues in a very comprehensive way in the years ahead and no one has a better champion of all of this, as senator harkin pointed out than our senator ted kennedy. he fought these battles for so many years and he understood you could never understand all of these issues and disapril points that he'd have in them. i know him well enough. if he could have written it on

his own, he would have written differently. i guarantee you as i stand here this evening, were he among us this evening, he would urge all of us to move forward on this bill to, address it, to vote for it, to allow this nation to begin to grapple with this issue that could have been solved more than 50 years ago. so this evening, again, as we come down to the final minutes of this debate, let us remind ourselves that i think history will judge us well for taking up this challenge once again and asking ourselves to give americans the opportunity to live freedom and freedom from those fears. >> that was senator chris dodd. >> and i remember a speech when he ran against jimmy carter

where he really laid out almost of the principles that the democrats were fighting for all this year for this mess and at the end of his life one of his greatest regrets was and it's one of the most consequential sloets any of us will ever take and none of us take ta lightly.

the people who wrote this bill were proud of it and an unnamed version or university the bill doesn't say where and no one will step forward to name it.

and just one insurance company in his state. do you think that's fair to all of your states. the year after the debate started a few people would have imagined that this is how a couple of cheap deals, a couple of cheap deals and a rush vote at 1:00 in the morning. by that's where you are. and americans are wondering

tonight how did this happen? how did this happen? i'd like to take a moment to explain to the american people how we got here, to explain what happened and, yes, what is happening now. now, everyone in this chamber agrees that we have health care. the question is how. some want us to tackle a cost issue and we proposed targeted steps to do it. our friends on the other side have taken the opposite approach. and the result has been just what you'd pekt, the final product is a meth. and so is the process that has

brought us here to vote on a bill that the american people overwhelmingly oppose. any challenge of this size and scope has always been dealt with on a by partisan basis about how these have been handled throughout our history. the social security act of 1935 was approved by all but six members of the senate. eight medicare act and the american with disabilities act

who voted no. that issues on this importance, one party should never be allowed to force its will on the other half of the nation. and departure from this history, they put together a bill so heavy with tax hikes, medicare cuts, and government intrusion that in the end the biggest problem was not getting republicans to support t. it was convincing the 2ke78 krats which

is exactly what this bill will be if it is passed. because in the end this debate isn't about differences between two parties. it's about 270033 page health care reform bill that does not reform health care and in fact makes the price of it go up. the plan i'm announcing tonight, the president said my plan, the president said, would bring down premiums by $2500 for the typical family.

i'll outline a plan that has a deficit, the president said, either now or in the future. and on taxes, we'll see any kind of tax increase he said he said he wouldn't cut medicare. he said people wouldn't lose their coverage and americans were promised an open and on honest debate when the president said on the campaign trail, not negotiating behind closed doors but bringing all parties together and broadcasting these negotiations on c-span.

well, that was then. but here's the reality. that's not me talking. it's the administration's oin score clz keeper. it raises premiums, that's the budget office talking. it raises taxes on tens of millions of middle class americans and plunders medicare by half a trillion dollars. it forces people off the plans that they have, including millions fs seniors. it allows the federal government for the first time in our history to use taxpayer dollars for abortions so a president who

was voted into office, on a promise of change, he said he wouldn't raise taxes. that changed, he said he wanted lower costs. that changed: he said he wouldn't change medicare and that changed, too. and 12 months and $2.3 trillion later, lawmakers who made the promise to constituents are poised to vote for a bill that won't bend the cost curve, that won't make health care more affordable and that will make real reform even harder to achieve down the road.

i understand how our friends are feeling and i don't doubt for a moment their sincerity. this will long out weigh the frantic snowy washington. mark my words, this legislation will reshape our nation. and americans are already issued their verdict. they don't want it.

let's think about that for a moment. we know that people are overwhelmingly opposed to this bill. and yet the people who wrote it will not give the lives that will be profoundly affected by it as much as 72 hours to study the details imagine that when we all woke up yesterday and when we woke up yesterday morning, we still haven't seen the details of the bill that we're going to be asked to vote on before we go to sleep tonight. how can anybody justify this

approach. can all of these americans be wrong? don't their concerns count? party loyalty can be a powerful source. we all know that. to put the seniors first and there is good news. it's not too late. all it takes is one. all it takes is one. one can stop it. one can stop it.

or everyone will own it. my colleagues, it's not too late. >> mr. president -- >> that was senator mitch mcconnell from kentucky. he's the minority leader now. let's listen to the majority leader, senator harry reid from nevada. >> more and more americans have come down with the flu, or even developed diabetes, suffered a

stroke more and more americans who have a skin condition are dying rather than being cared. and much more of our attention has consumed this health care debate and the national study than by harvard university found that 4500 times this year more than 120 times per day, an average of 10 every ten minutes, an american died as a result the numbers are numbing. they don't even include those that have had health insurance but died because they couldn't

afford a plan that met their most basic needs. they are the only place that they are dying for lack of possible. to make matters worst, we are paying for that privilege. so do numbers that can't afford. medical bills are the leading cause of bankruptcy in america. we have before us the ability to provide quality health care to every american and we have the ability to treat our unhealthy health care system.

this make it is illegal because of pre-existing conditions. mr. president, and extending the life for almost a decade, taking the first step to close notorious loophole known as the don not hole that costs seniors thousands of dollars each year for the prescription drugs. and these are some of the reasons that aarp, the american association for the advancement of -- american association of retired people, not the naacp -- i'm sorry about that, mr. president. these are some of the reasons that aarp and 4 million americans are supporting this bill. premiums are reduced for this, mr. president, by 93% of people

who will have reduced premiums. this strengthens our fump by cutting our deficit by as much as $1.3 trillion over the next two deck it's a. that's trillion with a t we want to help shape the deliver resystem in our count try. that right in america has 750,000 bankruptcy as year.

and it advances the first time in the country that good health will not depend on great wealth. good health should not depend on how much money you have. it acknowledges finally the health care is a fundamental right, that my friend, senator harkin spoke about so clearly. not just a privilege for the most fortunate. president johnson, formerly majority of the united states senate, signed meca